… with their promises of quick results and cleaner digestive systems. But are these quick-fix regimens really safe and effective?

Aug. 20, 2009

Written by

Darla Carter

Since ancient times, people have sought to purify their bodies. This desire is reflected in the current popularity of “detox diets,” colon-cleansing regimens and similar programs that also are used by people trying to lose weight or to get on the path to healthy living.

Hollywood may be fueling their popularity, as celebrities often cite these regimens as their secret to squeezing into Oscar gowns or dropping a few sizes — fast — for a movie role.

The idea of ridding the body of “toxins,” or shedding pounds without the usual effort, might seem like a good idea. But it's not necessarily as healthful or as efficient as it may seem when you see the so-called results on the red carpet.

“These types of detox diets really aren't necessary, and there really isn't any scientific basis behind them to prove any kind of necessity,” says Andrea Giancoli, a spokeswoman for the American Dietetic Association. “In a healthy individual, we already have several detoxing mechanisms … in place that are fantastic: Our liver, our kidneys, our digestive system, our lungs, etc., are our natural detoxifiers, so we don't really need a so-called detox diet.”

Dr. Julie Temes Ellis, an internist with Associates in Internal Medicine in Louisville, agrees there's no proof that “colon cleansing” programs are any better than the body's own natural processes: “Your body is like a self-cleaning oven,” she says.

Bowel regularity is important, and sometimes people do need help to achieve that. For example, they may need to alter their diet by consuming more fiber or drinking more water, or they may need to take stool softeners or a laxative, such as Miralax, says Dr. Stephen McClave, professor of medicine and director of clinical nutrition at the University of Louisville. He also says “there is a time for enemas,” although not the coffee ones touted on the Internet.

“We use enemas to prep for certain procedures,” says McClave, a gastroenterologist. “There's cases where you have chronic constipation, and you've got to re-establish bowel regularity. That's different from these very dramatic oral cleansing regimens or these high-colonic, enema-type therapies.

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“There's nothing in our GI (gastrointestinal) literature that suggests that these drastic diets or these enema regimens on a regular basis in somebody that's asymptomatic (are) important.”

Nor are such programs a long-term weight-loss solution, despite USA Today's report that Beyoncé lost 20 pounds on a cleansing diet that replaced normal food with a mixture of fresh lemon juice, organic maple syrup, cayenne pepper and water.

“Yeah, you'll lose weight” by doing something like that, Ellis says. “But as soon as you stop drinking it and eat normal food, there it (the weight) is again.”

People sometimes are attracted to gimmicky regimens such as colon cleanses and high-colonics (which are enemas that inject large amounts of fluid high into the colon for cleansing purposes) because they want to free the body of things like alcohol and caffeine.

But “that suggests that we store alcohol or store caffeine, and that's not true,” McClave says. “It's metabolized and eliminated like any other drug, so the idea that you've been drinking like a fish for six months and you're going to get a high-colonic or a week of some cleansing oral thing that's going to wash out six months of alcohol has no scientific basis.”

He also rejects the idea that a cleansing regimen can protect someone from potentially cancer-causing chemicals.

Some studies suggest that consuming large amounts of processed meat increases the risk of cancer and that frying, broiling or grilling meats at very high temperatures forms chemicals that might increase cancer risk, according to the American Cancer Society. But “it's usually a lifelong pattern of eating that affects your risk, and, again, the idea that a high-colonic treatment today would make up for 15 years of eating grilled meats is silly,” McClave says.

Some programs claim that it's necessary to cleanse the body of bacteria, but certain bacteria in the intestinal tract actually have beneficial effects, says McClave. For example, he says, “it's very important to have good bacteria in your gut” because they help to keep bad bacteria, such as pseudomonas, from making you sick.

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Before you start

Before embarking on any new program or regimen, it's a good idea to consult with your physician, especially if you have a medical condition, such as kidney disease, or are on medication.

Ask whether the program would be risky for you, given your personal history and health, how long it would be advisable to be on it (if at all), and how it will impact your intake of calories and other important dietary components, such as protein.

A multi-vitamin may be recommended if you're on something like a juice fast. Bowel-cleansing can result in electrolyte abnormalities and put people at risk for cardiac dysrhythmia, muscle cramps and dehydration, McClave says. And very low-calorie diets, such as those limited to 600 to 800 calories a day, have a “high risk of electrolyte and micronutrient deficiencies” and therefore should be medically supervised, he says.

Moderate fasting may be OK

Some research indicates that intermittent or moderate fasting, such as one day a week, can be beneficial.

Potential benefits include adjusting the body's hunger cycle; making the body more sensitive to insulin, which helps maintain normal blood sugar levels; and possibly reducing the risk of disease, according to a Los Angeles Times article. “It does seem that people's attitudes can get kind of a jump-start from going on a fast for a day,” but medical conditions and medications have to be considered, said Giancoli of the American Dietetic Association, who is a registered dietitian in Los Angeles.

Some diets and colon cleansers involve herbal or “natural” supplements, but supplements do not undergo the same federal scrutiny as prescription drugs and might interfere with medications you're taking.

“There's a misconception that just because it's natural, it's safe,” McClave says. “You have to be extremely careful.” Giancoli offers a similar warning: “You should be cautious with anything that requires a lot of supplements,” she says. With some supplements, “there's not a lot of research behind them for safety, much less effectiveness. You're playing a guinea pig.”

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Ellis, who's part of The Physician Group at Jewish Hospital & St. Mary's HealthCare, says patients sometimes ask her about fad diets and regimens as a way to lose weight quickly and easily, but she tries to steer them in another direction.

“When people are talking seriously about weight loss and weight control, what (they) really need is a long-term solution, such as what we all know: More energy expenditure out than in,” she says. They need “well-balanced diets with healthy, whole foods and (to) increase their exercise.”

But that's generally not what patients want to hear, she says, since they're usually looking for a magic bullet.

Be skeptical about weight-loss plans or cleansing regimens that promise to drop large amounts of weight quickly, McClave says, noting that a safe rate of weight loss is 1 to 2 pounds per week.

“A lot of these detox diets are really quick-weight-loss schemes, and if you lower your calories significantly, you're going to lose weight,” Giancoli says. “Will you keep that weight off? Very unlikely.”